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Choice between Levofloxacin and Moxifloxacin and Multidrug-Resistant Tuberculosis Treatment Outcomes

Authors
 Young Ae Kang  ;  Tae Sun Shim  ;  Won-Jung Koh  ;  Se ung Heon Lee  ;  Chang-Hoon Lee  ;  Jae Chol Choi  ;  Jae Ho Lee  ;  Seung Hun Jang  ;  Kwang Ha Yoo  ;  Ki Hwan Jung  ;  Ki Uk Kim  ;  Sa ng Bong Choi  ;  Yon Ju Ryu  ;  Kyung Chan Kim  ;  Soojung Um  ;  Yong-Soo Kwon  ;  Yee Hyung Kim  ;  Won-Il Choi  ;  Kyeongman Jeon  ;  Yong Il Hwang  ;  Se Joong Kim  ;  Hyun-Kyung Lee  ;  Eunyoung Heo  ;  Jae-Joon Yim 
Citation
 ANNALS OF THE AMERICAN THORACIC SOCIETY, Vol.13(3) : 364-370, 2016 
Journal Title
 ANNALS OF THE AMERICAN THORACIC SOCIETY 
ISSN
 2329-6933 
Issue Date
2016
MeSH
Adult ; Anti-Bacterial Agents/administration & dosage* ; Anti-Bacterial Agents/adverse effects ; Female ; Fluoroquinolones/administration & dosage* ; Fluoroquinolones/adverse effects ; Humans ; Levofloxacin/administration & dosage* ; Levofloxacin/adverse effects ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/drug therapy*
Keywords
fluoroquinolones ; levofloxacin ; moxifloxacin ; multidrug-resistant tuberculosis
Abstract
RATIONALE: We previously showed that the choice of levofloxacin or moxifloxacin for the treatment of patients with fluoroquinolone-sensitive multidrug-resistant tuberculosis (MDR-TB) did not affect sputum culture conversion at 3 months of treatment. OBJECTIVES: To compare final treatment outcomes between patients with MDR-TB randomized to levofloxacin or moxifloxacin. METHODS: A total of 151 participants with MDR-TB who were included for the final analysis in our previous trial were followed through the end of treatment. Treatment outcomes were compared between 77 patients in the levofloxacin group and 74 in the moxifloxacin group, based on the 2008 World Health Organization definitions as well as 2013 revised definitions of treatment outcomes. In addition, the time to culture conversion was compared between the two groups. MEASUREMENTS AND MAIN RESULTS: Treatment outcomes were not different between the two groups, based on 2008 World Health Organization definitions as well as 2013 definitions. With 2008 definitions, cure was achieved in 54 patients (70.1%) in the levofloxacin group and 54 (73.0%) in the moxifloxacin group (P = 0.72). Treatment success rates, including cure and treatment completed, were not different between the two groups (87.0 vs. 81.1%, P = 0.38). With 2013 definitions, cure rates (83.1 vs. 78.4%, P = 0.54) and treatment success rates (84.4 vs. 79.7%, P = 0.53) were also similar between the levofloxacin and moxifloxacin groups. Time to culture conversion was also not different between the two groups (27.0 vs. 45.0 d, P = 0.11 on liquid media; 17.0 vs. 42.0 d, P = 0.14 on solid media). Patients in the levofloxacin group had more adverse events than those in the moxifloxacin group (79.2 vs. 63.5%, P = 0.03), especially musculoskeletal ones (37.7 vs. 14.9%, P = 0.001). CONCLUSIONS: The choice of levofloxacin or moxifloxacin made no difference to the final treatment outcome among patients with fluoroquinolone-sensitive MDR-TB. Clinical trial registered with www.clinicalrials.gov (NCT01055145).
Full Text
http://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201510-690BC#.WARoq_mLSHs
DOI
10.1513/AnnalsATS.201510-690BC
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146747
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